Nitrogen-sparing intravenous fluids in postoperative patients

N Engl J Med. 1975 Jul 24;293(4):172-5. doi: 10.1056/NEJM197507242930404.

Abstract

Improved nitrogen sparing was demonstrated in 20 patients undergoing either head-and-neck operations or abdominal explorations, who were randomized to receive intravenously either 3 per cent amino acids or 5 per cent dextrose. Infusions were started immediately after operation and continued for a minimum of six days. In patients receiving amino acids, as compared with those receiving dextrose, mean cumulative six-day nitrogen losses were significantly lower (42 plus or minus 5 g [S.E.M.] and 74 plus or minus 7 g, respectively--P smaller 0.005), as were serum glucose and insulin levels, but beta-hydroxybutyrate, acetoacetate and blood urea nitrogen were significantly elevated. No adverse effects of the amino acid solution were observed. The presumed mechanism for improved nitrogen sparing is a decrease in serum glucose and insulin levels, allowing greater endogenous fat mobilization and utilization, thus sparing lean body mass.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acetoacetates / blood
  • Amino Acids / administration & dosage*
  • Amino Acids / metabolism
  • Blood Glucose / analysis
  • Blood Proteins / analysis
  • Blood Urea Nitrogen
  • Dietary Proteins / administration & dosage
  • Glucose / administration & dosage
  • Humans
  • Hydroxybutyrates / blood
  • Infusions, Parenteral
  • Insulin / blood
  • Ketone Bodies / blood
  • Lipid Mobilization
  • Nitrogen / metabolism*
  • Parenteral Nutrition*
  • Postoperative Care*
  • Solutions
  • Time Factors

Substances

  • Acetoacetates
  • Amino Acids
  • Blood Glucose
  • Blood Proteins
  • Dietary Proteins
  • Hydroxybutyrates
  • Insulin
  • Ketone Bodies
  • Solutions
  • Glucose
  • Nitrogen